Understanding Endocarditis: Causes, Symptoms, and Treatments
Endocarditis is a serious condition of the medical variety that causes infection and inflammation of the heart’s inner lining, or endocardium. The disease most commonly involves the heart valves, which are essential constituents for preserving the flow of blood. Life-threatening consequences like heart failure, stroke, or serious organ damage can result from endocarditis if left untreated.
Whether you already have a heart condition or just want to learn more, knowing about the causes, signs, and treatments of endocarditis is the first step to protect your heart from harm.
Anatomy Refresher: What is the Endocardium?
The endocardium is a smooth, thin membrane that lines the heart chambers and valves. It is naturally designed to allow the easy flow of blood and to avoid the formation of clots. The mitral, aortic, tricuspid, and pulmonary valves of the heart are particularly vulnerable because they are a component of a continuously circulating network of chambers and veins that can act as a surface for bacteria or fungi to attach to and subsequently grow.
When that endocardium or those heart valves have been damaged (from birth defects, prior surgeries, or other medical problems), they are more likely to become infected. That’s why people who have artificial heart valves or who developed valve disease are at greater risk.
Causes and Risk Factors
Endocarditis develops when bacteria, fungi or other germs enter the bloodstream and clamp onto damaged areas of the heart. Some common causes for infection are:
- Oral surgery (particularly if the gums are bleeding)
- Infections of the skin (from cuts or abscesses)
- Injecting drugs through sharing syringes, needles, or drug solutions contaminated with the virus.
- Catheters (especially chronic urinary or IV)
Who is at Risk?
Endocarditis can occur in anyone, but the following people are at increased risk:
- Those with prosthetic heart valves
- With past history of heart valve disease
- Those born with heart disease
- Patients with a history of endocarditis
- People with weakened immune systems, such as those with HIV infection or those undergoing chemotherapy
Types of Endocarditis
There are various manifestations of endocarditis based on the rate of progression and the causative agent:
- Acute Endocarditis – Appears suddenly and worsens quickly and is usually caused by aggressive bacteria such as Staphylococcus aureus.
- Subacute or Chronic Endocarditis – Progresses more gradually over a period of weeks or months and is usually the work of less virulent bacteria (i.e., Streptococcus viridans).
- Infective Endocarditis (IE) – The most common, this is typically due to bacterial or fungal infection.
Signs and Symptoms
Symptoms of endocarditis in the early stages can be nonspecific and flu-like. But as the infection advances, you might experience worse symptoms.
Early Warning Signs:
- Fever and chills
- Fatigue and muscle aches
- Night sweats
- Unexplained weight loss
Advanced Symptoms:
- Shortness of breath
- Abnormal heart sounds (Murmurs)
- Fluid on the legs or tummy (oedema)
- Petechial rash (a rash of small red or purple spots on the skin)
Unresolved Issues:
- Heart failure (as a result of damage to the valves)
- Stroke (because infected clots can break loose)
- Valve damage necessitating replacement by surgery
- End-organ damage (from septic emboli)
Diagnosis
If endocarditis is suspected, a doctor will perform a physical exam along with:
- Medical history and physical exam (looking for heart murmurs and risk factors)
- Blood tests (to evaluate platelet count and other factors that could affect healing)
- Blood cultures (to detect bacteria or fungi)
- An echocardiogram is a test that creates images of the heart and its valves using sound waves.
- ECG, chest X-ray (to evaluate the pumping of the heart and to check for complications)
- CT or MRI scan (if embolisms or abscesses are indicated)
Treatment Options
Antibiotic/Antifungal Therapy
- Intravenous (IV) antibiotics (they may be given for 4–6 weeks)
- Specific to the micro-organism causing the infection, converse treatment
Surgical Intervention
- Indicated if moderate to severe valve damage or persistent infection
- Procedures could involve repair or replacement of the valve
Admission and Surveillance
- Prevention and management of infections combined with ongoing heart state monitoring
Preventing Endocarditis
Prevention is everything, particularly for high-risk patients. Recommendations include:
- Antibiotics before dental or surgical work (only if recommended by your cardiologist)
- Good oral hygiene, which includes routine dental examinations and brushing and flossing
- Preventing IV drug use and maintaining clean catheter care
- Routine heart screenings in people with artificial valves or congenital heart disease
Living with and After Endocarditis
Recovery time depends on the nature of the infection. Patients may need:
- Extended antibiotic therapy
- Changes in lifestyle (such as heart-healthy eating, exercise, and stopping smoking)
- Long-term surveillance of heart function and recurrence
When to See a Doctor
Contact a doctor straight away if you experience:
- Cardiac disease as well as unremitting fever
- Unexplained fatigue, shortness of breath (SOB), or oedema
- Neurological symptoms of stroke (weakness or speech loss)
Conclusion
Endocarditis is a serious but treatable condition. Awareness of the symptoms, risk factors, and preventive measures can significantly reduce the likelihood of severe complications. If you or a loved one have a heart condition or experience concerning symptoms, early medical intervention is crucial.
For expert cardiac care and personalised treatment plans, contact Chase Lodge Hospital today. Your heart health is our priority.
